asked the Minister for Social Welfare the present position regarding the extension of dental treatment to the spouses of insured workers; the total number of dentists who are operating the scheme at the latest date for which figures are available; if the recently announced increase in fees is being paid to dentists who are refusing to operate the extended scheme; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Extended Dental Scheme.
15.
I propose to take Questions Nos. 3 and 15 together.
I have had two meetings with representatives of the Irish Dental Association since the completion of the report of the Joint Working Group on the Social Insurance Dental Benefit scheme in July. My officials also had several meetings and have been in frequent contact with representatives of the association over the same period. Following a previous meeting with the association I set up this working group in the light of the association's opposition to the extension of the dental benefit scheme to the dependent spouses of insured persons, mainly wives working in the home, and with a view to seeing whether improvements could be devised which would open the way to full participation by dentists in the extended scheme.
The association in the context of the joint working group sought fundamental changes in the scheme which I could not accept and it was not possible to reach an agreement in the context of the discussions in the group. Officials of my Department met the association in November 1988. I met them again in December 1988 and discussed with them the possibility of certain improvements in the scheme. A further meeting at official level was held in January 1989.
Since it was not possible to reach agreement with the association I implemented a substantial package of practical improvements to the scheme in line with discussions which had taken place with the association's representatives. These improvements have been notified to each member of my Department's dental panel. They will apply to claims from all dentists from today, 1 March.
A total of 36,363 dental claims in respect of dependent spouses have been received to date. Those claim figures and the very high level of treatment required by the claimants, bear out the considerable need which there was for this extension to dependent spouses. One hundred and eighty-three dentists countrywide have signed new agreements covering the extended scheme. Twenty six dentists have returned from abroad (24 from the UK) and are operating the scheme which includes the dependent spouses.
Some complaints have recently been received from patients that they have been refused certain items of treatment covered under the dental benefit scheme. It is understood that this is as a result of a motion passed at an Irish Dental Association conference, recommending that their members cease providing these treatments. Further inquiries are being made regarding the complaints and if these complaints are substantiated I will have no alternative but to apply the appropriate sanctions provided for in each dentist's personal contract.
I regard the Minister's reply as a total abuse of the priority question procedure. The answer to my question is either one or two. I understood the answer was one. The Minister says he has met the members of the Irish Dental Association twice. However, I will not waste the time of the House. Will the Minister accept that in the resolution of a difficult dispute the most important thing is to keep lines of communication open and the worst thing that can be done is to address the members on the other side of the fence by way of megaphone diplomacy issuing ultimata and that carrying on in the way the Minister has carried on is total arrogance towards the case made by them?
I think the Deputy is probably, understandably, not fully familiar with the details of what has taken place and the importance of the scheme. The Deputy might remember that this House unanimously favoured the extension of this scheme to dependent spouses. Since it was extended in October 1987 the Irish Dental Association have opposed that extension as vigorously as they possibly could. Notwithstanding that, 183 dentists signed and operated the extended scheme.
I have tried to work along the lines agreed in the House to ensure the continuation of the service which we have been providing. This is a very excellent scheme. I would like to see it operating fully in all areas of the country. I greatly appreciate the work of those dentists who have provided a service for dependent women working in the home and I look forward to the co-operation of all dentists on the panel in the future.
In relation to the meetings, the difficulty I had with the Irish Dental Association most recently, and perhaps the one to which the Deputy refers, is that the Irish Dental Association made it quite clear that they wanted a two-tier system based on medical card guidelines which involved increased fees and charges on insured workers effectively without limits, with those who are strictly on medical card guidelines getting the existing treatments. This was not acceptable to me. I considered that it would under-mine the insured workers PRSI scheme and would involve substantial increases in cost for insured workers for treatment. I could not meet those demands but I have met many of the requirements and I have improved the scheme substantially.
Before the Minister wastes any further time, would he accept that in relation to the two tier system he himself has increased charges on insured workers? Second, to finish the matter, will the Minister now tell me that he will sit down with the officials of the Irish Dental Association in a real effort to solve this problem now? Could I have a yes or a no to that?
The time has come to go on to other questions.
The answer is not as simple as that. I am certainly prepared to discuss any matters that will lead to the resolution of the problem and the extension of the scheme to all those who are entitled under the scheme as it exists. I mentioned the letter which was received by my Department on 25 January in which the Irish Dental Association set out the basis on which they would consider extending the scheme and it was: (a) to negotiate agreed fees for the treatment of lower income eligible patients and (b) that optional grant-in-aid would apply to the majority of treatment procedures for patients whose income level is in excess of the income level for medical card holders. I think the Deputy would agree that he would not like to see the scheme taken apart in that way and virtually dismantled.
The Minister should meet them.
The Chair has an obligation to adhere to the Standing Orders governing Priority Questions.
The latest position, as stated by the Irish Dental Association in their press releases, is that they are now talking about out of date services on uneconomic fees paid by the Department of Social Welfare. I am quite prepared to discuss that aspect but I am not prepared to dismantle the PRSI workers' scheme.
On a point of order, would it be in order for me to raise a supplementary question on Question No. 15 which is an ordinary question as we are now outside Priority Questions Time?
No, it would not.
We are now outside our Priority Question Time.
Your question is related to a Priority Question.
On a point of order which has nothing to do with Priority Questions but is a separate issue, in relation to the refusal by the Minister to deal with the question which I tabled about a scheme he introduced last September, I put down a question inquiring why the educational opportunities scheme was not being implemented, and the Minister transferred it on to the Minister for Education.
I have no control over that aspect of the matter.
Surely that is a further abuse of this House.
Question No. 6, please.
The Minister should tell the House ——
Please, Deputy O'Keeffe.
The scheme is operated by the Minister for Education and we release people for it.
It was accepted with great fanfare by the Minister for Social Welfare.
That does not do you any good, Deputy. I propose to take Questions Nos. 4, 5 and 17 together.
I am sorry, Minister, Nos. 4 and 5 are Priority Questions, the time for which has passed. We are dealing now solely with ordinary questions.
Then I propose to take Nos. 17, 4 and 5.
Only when we reach No. 17.
I am sorry about that. Deputy O'Keeffe, Deputy Harney and Deputy O'Malley.